Presentation (CTI)

OBJECTIVES: Endometrial cancer is the most prevalent gynecological cancer in the United States. Advanced-stage disease is associated with a poor prognosis, with metastases serving as a primary driver of mortality. This study aimed to evaluate and compare survival outcomes in patients with stage IV endometrial cancer with and without lung metastasis using data from the Surveillance, Epidemiology, and End Results (SEER) database.
METHODS: We conducted a retrospective cohort analysis using the SEER Research Database (2000-2019, 17 Registries). Cases diagnosed between 2010 and 2015 were included based on the following criteria: (1) primary tumor sites coded as, C54.1-9 and C55.9 per the International Classification of Diseases for Oncology; (2) diagnosis year 2010-2015; (3) AJCC stage IV; and (4) age ≥18 years. Patients were categorized into two cohorts: those with lung metastasis and those without. Survival rates were estimated using Kaplan-Meier analysis, and adjusted Hazard Ratios (aHR) with 95% confidence intervals (CI) were calculated using Cox proportional hazards models.
RESULTS: This study cohort included 5,203 patients with stage IV endometrial cancer. Nearly 30% of cases (n= 1563) presented with lung metastasis at baseline. Lung metastasis was associated with older age (60-79 years) and advanced stage (stage IVB). Cancer-specific mortality was observed in 4,342 patients (83.45%). The 5-year survival rate was 10.3% in the lung metastasis cohort compared to 19.8% in the cohort without lung metastasis. The unadjusted HR for mortality in the lung metastasis cohort was 1.64 (95% CI 1.54-1.78), and the aHR was 1.61 (95% CI 1.51-1.72).
CONCLUSIONS: Patients with stage IV endometrial cancer and lung metastasis exhibit a higher risk of mortality compared to those without lung metastasis. These findings underscore the aggressive nature of metastatic disease and highlight the need for targeted therapeutic strategies to improve survival outcomes, especially in high-risk populations.